Epidural ropivacaine infusion as part of a multimodal postoperative pain treatment following thoracolumbar spinal fusion surgery, a randomised controlled trial

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Samenvatting

Background : Pain management after posterior
thoracolumbar interbody fusion surgery remains a
challenging problem. Epidural analgesia with local
anesthetics as an adjuvant treatment might prove
beneficial.

Objective : To evaluate the effects of continuous epidural
analgesia with a ropivacaine solution as an adjuvant
treatment after posterior thoracolumbar interbody fusion.
Study design : A prospective double-blind, randomized,
placebo-controlled clinical trial. Setting : University
Hospital Brussels, a tertiary academic health science
centre.

Methods : Thirty-three patients undergoing spinal fusion
surgery were randomized into two groups. One group
was administered a continuous epidural infusion of a
0.9% saline solution. The other group was administered
a continuous epidural infusion of a 0.2% ropivacaine
solution. The primary outcome measure was the level
of pain experienced by the patients, which was assessed
using the visual analogue scale (VAS). Secondary
outcomes were time to mobilisation, total length of stay
and opioid consumption on patient demand.

Results : The mean VAS score postoperatively the day
of surgery was scored as 3,5 for the patients receiving
the ropivacaine infusion. The placebo group scored
5 on the VAS scale, thus suggesting a beneficial effect
of ropivacaine infusion (p-value 0.02). The mean VAS
score at post-op day 1 of surgery differed between 2
for the ropivacaine group and 2,8 for the placebo group
(p-value 0.05). Length of stay was shorter for patients
who had received ropivacaine infusion (mean difference
1,8 days ; p-value 0,02). No other significant differences
were withheld.

Conclusion : The use of a continuous epidural
ropivacaine infusion after posterior thoracolumbar spinal
fusion surgery could improve postoperative VAS scores
and may also result in faster hospital discharge rate. Trial
registration : registered and approved in the EudraCT
registry (2014-004713-91).
Originele taal-2English
Pagina's (van-tot)197-201
Aantal pagina's5
TijdschriftActa Anaesthesiologica Belgica
Volume71
Nummer van het tijdschrift1
StatusPublished - 2020

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